Individual-Level Interventions for Decreasing Job-Related Stress and Enhancing Coping Strategies Among Nurses: A Systematic Review

Maria Velana, Gerhard Rinkenauer, Maria Velana, Gerhard Rinkenauer

Abstract

Background: Nurses are facing unprecedented amounts of pressure because of the ongoing global health challenges. Improving nurses' resilience to job-related stress and enhancing their strategies to cope effectively with stressors are key issues facing many health care institutions during the COVID-19 pandemic. This literature review aimed to: a) provide a thorough overview of individual-level interventions for stress management among nurses, b) identify measurement tools utilized to evaluate nurses' stress level, and c) provide the best evidence-based recommendations for future research and practice adapted to the current restrictions. Design: Systematic review. Data Sources: Studies published between January 2000 and October 2020 were retrieved from the following sources: EBSCOhost, Dortmund University Library, PubMed, Medline, Google Scholar, Applied Nursing Research, and reference lists from relevant articles. Review methods: Individual-level interventions with a control group or a placebo intervention were included in the final sample. Primary outcome was defined as a change in individual stress level or stress symptoms which were measured by objective or subjective instruments with evidence of validity. Articles published in English or German were included in the present review. Results: In total, 27 relevant studies were included into the current review. There are some indications that technology-delivered interventions with relaxation and stress management interventions comprising cognitive-behavioral components might be effective in decreasing stress among nurses and improving their well-being. Furthermore, although there were some attempts to collect objectively measured parameters for assessing the primary outcome of stress, the majority of the interventions utilized self-reported stress scales. Conclusion: A wide range of interventions are available for nurses. However, it is of utmost importance to develop and implement stress management programs that are conveniently accessible in the workplace and above all, meet the current restrictions for minimizing human contacts. To this end, innovative interventions delivered through digital technology, such as virtual reality, seem to be a promising solution for combating the detrimental impact of stress on nurses. Special attention should be also paid to applying standardized objective measurement tools to allow the assessment of sensitive physiological indices and the generalizability of scientific knowledge.

Keywords: coping strategies; job-related stress; nurses; objective measurement tools; stress management; technology-delivered interventions.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Velana and Rinkenauer.

Figures

Figure 1
Figure 1
Search strategy for the inclusion and exclusion of articles based on a modified version of PRISMA flow diagram (Moher et al., 2009).

References

    1. Aguilera G. (2011). HPA axis responsiveness to stress: implications for healthy aging. Exp. Gerontol. 46, 90–95. 10.1016/j.exger.2010.08.023
    1. Alkhawaldeh J. M., Soh K. L., Mukhtar F., Peng O. C., Alkhawaldeh H. M., Al-Amer R., et al. . (2020). Stress management training program for stress reduction and coping improvement in public health nurses: a randomized controlled trial. J. Adv. Nurs. 76, 3123–3135. 10.1111/jan.14506
    1. Arnetz J. E., Goetz C. M., Arnetz B. B., Arble E. (2020). Nurse reports of stressful situations during the COVID-19 pandemic: qualitative analysis of survey responses. Int. J. Environ. Res. Public Health 17:21. 10.3390/ijerph17218126
    1. Bahmanzadeh L., Haji Alizadeh K. (2017). The effect of cognitive–behavioral stress management training on improving psychological symptoms and quality of life in nurses. J. Res. Health 7, 1154–1161.
    1. Bakker E. J. M., Kox J., Boot C. R. L., Francke A. L., van der Beek A. J., Roelofs P. (2020). Improving mental health of student and novice nurses to prevent dropout: a systematic review. J. Adv. Nurs. 76, 2494–2509. 10.1111/jan.14453
    1. Bernburg M., Groneberg D., Mache S. (2020). Professional training in mental health self-care for nurses starting work in hospital departments. Work 67, 583–590. 10.3233/WOR-203311
    1. Bernburg M., Groneberg D. A., Mache S. (2019). Mental health promotion intervention for nurses working in German psychiatric hospital departments: a pilot study. Issues Ment. Health Nurs. 40, 706–711. 10.1080/01612840.2019.1565878
    1. Bosma H., Marmot M. G., Hemingway H., Nicholson A. C., Brunner E., Stansfeld S. A. (1997). Low job control and risk of coronary heart disease in whitehall II (prospective cohort) study. BMJ 314, 558–565. 10.1136/bmj.314.7080.558
    1. Calder Calisi C. (2017). The effects of the relaxation response on nurses' level of anxiety, depression, well-being, work-related stress, and confidence to teach patients. J. Holist. Nurs. 35, 318–327. 10.1177/0898010117719207
    1. Chatterjee S., Saha I., Mukhopadhyay S., Misra R., Chakraborty A., Bhattacharya A. (2014). Depression among nursing students in an Indian government college. Br. J. Nurs. 23, 316–320. 10.12968/bjon.2014.23.6.316
    1. Chesak S. S., Cutshall S. M., Bowe C. L., Montanari K. M., Bhagra A. (2019). Stress management interventions for nurses: critical literature review. J. Holist. Nurs. 37, 288–295. 10.1177/0898010119842693
    1. Cohen-Katz J., Wiley S. D., Capuano T., Baker D. M., Shapiro S. (2005). The effects of mindfulness-based stress reduction on nurse stress and burnout, Part II: a quantitative and qualitative study. Holist. Nurs. Pract. 19, 26–35. 10.1097/00004650-200501000-00008
    1. Collier L., Staal J., Homel P. (2018). Multisensory environmental therapy (Snoezelen) for job stress reduction in mental health nurses: a randomized trial. Int. J. Altern. Complement. Med. 11:2. 10.15406/ijcam.2018.11.00346
    1. Cottrell S. (2001). Occupational stress and job satisfaction in mental health nursing: focused interventions through evidence-based assessment. J. Psychiatr. Ment. Health Nurs. 8, 157–164. 10.1046/j.1365-2850.2001.00373.x
    1. Delgado C., Upton D., Ranse K., Furness T., Foster K. (2017). Nurses' resilience and the emotional labour of nursing work: an integrative review of empirical literature. Int. J. Nurs. Stud. 70, 71–88. 10.1016/j.ijnurstu.2017.02.008
    1. Eatough E. M., Chang C. H., Miloslavic S. A., Johnson R. E. (2011). Relationships of role stressors with organizational citizenship behavior: a meta-analysis. J. Appl. Psychol. 96, 619–632. 10.1037/a0021887
    1. Edwards D., Burnard P. (2003). A systematic review of stress and stress management interventions for mental health nurses. J. Adv. Nurs. 42, 169–200. 10.1046/j.1365-2648.2003.02600.x
    1. Ghawadra S. F., Abdullah K. L., Choo W. Y., Phang C. K. (2019). Mindfulness-based stress reduction for psychological distress among nurses: a systematic review. J. Clin. Nurs. 28, 3747–3758. 10.1111/jocn.14987
    1. Ghawadra S. F., Lim Abdullah K., Choo W. Y., Danaee M., Phang C. K. (2020). The effect of mindfulness-based training on stress, anxiety, depression and job satisfaction among ward nurses: a randomized control trial. J. Nurs. Manag. 28, 1088–1097. 10.1111/jonm.13049
    1. Gollwitzer P. M., Mayer D., Frick C., Oettingen G. (2018). Promoting the self-regulation of stress in health care providers: an internet-based intervention. Front. Psychol. 9:838. 10.3389/fpsyg.2018.00838
    1. Golshiri P., Pourabdian S., Najimi A., Zadeh H. M., Hasheminia J. (2012). Job stress and its relationship with the level of secretory IgA in saliva: a comparison between nurses working in emergency wards and hospital clerks. J. Pak. Med. Assoc. 62, S26–S30.
    1. Hatcher B. J., Bleich M. R., Connolly C., Davis K., Hewlett P. O., Hill K. S. (2006). Wisdom at Work: The Importance of the Older and Experienced Nurse in the Workplace. Available online at: . (accessed May 29, 2021)
    1. Herman J. P., McKlveen J. M., Ghosal S., Kopp B., Wulsin A., Makinson R., et al. . (2016). Regulation of the hypothalamic-pituitary-adrenocortical stress response. Compr. Physiol. 6, 603–621. 10.1002/cphy.c150015
    1. Hersch R. K., Cook R. F., Deitz D. K., Kaplan S., Hughes D., Friesen M. A., et al. . (2016). Reducing nurses' stress: A randomized controlled trial of a web-based stress management program for nurses. Appl. Nurs. Res. 32, 18–25. 10.1016/j.apnr.2016.04.003
    1. Home J. F., Orr J. E. (1998). Assessing behaviors that create resilient organizations. Employ. Relat. Today 24, 29–39. 10.1002/ert.3910240405
    1. Hsieh H. F., Huang I. C., Liu Y., Chen W. L., Lee Y. W., Hsu H. T. (2020). The effects of biofeedback training and smartphone-delivered biofeedback training on resilience, occupational stress, and depressive symptoms among abused psychiatric nurses. Int. J. Environ. Res. Public Health 17:8. 10.3390/ijerph17082905
    1. Hwang W. J., Jo H. H. (2019). Evaluation of the effectiveness of mobile app-based stress-management program: a randomized controlled trial. Int. J. Environ. Res. Public Health 16:21. 10.3390/ijerph16214270
    1. Jackson D., Firtko A., Edenborough M. (2007). Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: a literature review. J. Adv. Nurs. 60, 1–9. 10.1111/j.1365-2648.2007.04412.x
    1. Johnston D., Bell C., Jones M., Farquharson B., Allan J., Schofield P., et al. . (2016). Stressors, appraisal of stressors, experienced stress and cardiac response: a real-time, real-life investigation of work stress in nurses. Ann. Behav. Med. 50, 187–197. 10.1007/s12160-015-9746-8
    1. Jones J. G. (1987). Stress in psychiatric nursing, in Stress in health professionals, eds Payne R., Firth-Cozens J. (Chichester: Wiley; ), 189–209.
    1. Kramer V., Papazova I., Thoma A., Kunz M., Falkai P., Schneider-Axmann T., et al. . (2020). Subjective burden and perspectives of German healthcare workers during the COVID-19 pandemic. Eur. Arch. Psychiatry Clin. Neurosci. 271, 271–281. 10.1007/s00406-020-01183-2
    1. Kurebayashi L. F. S., Gnatta J. R., Borges T. P., de Silva M. J. P. (2012). Applicability of auriculotherapy in reducing stress and as a coping strategy in nursing professionals. Rev. Lat. Am. Enfermagem 20, 980–987. 10.1590/S0104-11692012000500021
    1. Lai J., Ma S., Wang Y., Cai Z., Hu J., Wei N., et al. . (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw. Open 3:e203976. 10.1001/jamanetworkopen.2020.3976
    1. Lary A., Borimnejad L., Mardani-Hamooleh M. (2019). The impact of a stress management program on the stress response of nurses in neonatal intensive care units: a quasi-experimental study. J. Perinat. Neonatal Nurs. 33, 189–195. 10.1097/JPN.0000000000000396
    1. Lazarus R. S., Folkman S. (1984). Stress, appraisal, and coping. New York: Springer
    1. Li H., Zhao M., Shi Y., Xing Z., Li Y., Wang S., et al. . (2019). The effectiveness of aromatherapy and massage on stress management in nurses: a systematic review. J. Clin. Nurs. 28, 372–385. 10.1111/jocn.14596
    1. Lin L., He G., Yan J., Gu C., Xie J. (2019). The effects of a modified mindfulness-based stress reduction program for nurses: a randomized controlled trial. Workplace Health Saf. 67, 111–122. 10.1177/2165079918801633
    1. Mackenzie C. S., Poulin P. A., Seidman-Carlson R. (2006). A brief mindfulness-based stress reduction intervention for nurses and nurse aides. Appl. Nurs. Res. 19, 105–109. 10.1016/j.apnr.2005.08.002
    1. Matousek R. H., Dobkin P. L., Pruessner J. (2010). Cortisol as a marker for improvement in mindfulness-based stress reduction. Complement. Ther. Clin. Pract. 16, 13–19. 10.1016/j.ctcp.2009.06.004
    1. McElligott D., Holz M. B., Carollo L., Somerville S., Baggett M., Kuzniewski S., et al. . (2003). A pilot feasibility study of the effects of touch therapy on nurses. J. N. Y. State Nurs. Assoc. 34, 16–24.
    1. McEwen B. S. (1998). Stress, adaptation, and disease: allostasis and allostatic load. Annal. New York Acad. Sci. 840, 33–44. 10.1111/j.1749-6632.1998.tb09546.x
    1. Moeini B., Hazavehei S. M. M., Hosseini Z., Aghamolaei T., Moghimbeigi A. (2011). The impact of cognitive-behavioral stress management training program on job stress in hospital nurses: applying PRECEDE model. J. Res. Health Sci. 11, 114–120.
    1. Moher D., Liberati A., Tetzlaff J., Altman D. G., The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Med. 6:e1000097. 10.1371/journal.pmed1000097
    1. Moustaka E., Constantinidis T. C. (2010). Sources and effects of work-related stress in nursing. Health Sci. J. 4, 210–216.
    1. Nazari F., Mirzamohamadi M., Yousefi H. (2015). The effect of massage therapy on occupational stress of Intensive Care Unit nurses. Iran J. Nurs. Midwifery Res. 20, 508–515. 10.4103/1735-9066.161001
    1. Niva Sekar L., Manikandan A., K M., T G., Shriraam V., et al. . (2020). Mahamantra chanting as an effective intervention for stress reduction among nursing professionals—a randomized controlled study. Advances in Integrative Medicine.
    1. Orly S., Rivka B., Rivka E., Dorit S. E. (2012). Are cognitive-behavioral interventions effective in reducing occupational stress among nurses? Appl. Nurs. Res. 25, 152–157. 10.1016/j.apnr.2011.01.004
    1. Palumbo M. V., Wu G., Shaner-McRae H., Rambur B., McIntosh B. (2012). Tai Chi for older nurses: a workplace wellness pilot study. Appl. Nurs. Res. 25, 54–59. 10.1016/j.apnr.2010.01.002
    1. Prado J. M. D., Kurebayashi L. F. S., Silva M. (2018). Experimental and placebo auriculotherapy for stressed nurses: randomized controlled trial. Rev. Esc. Enferm. USP. 52:e03334. 10.1590/s1980-220x2017030403334
    1. Pulido-Martos M., Augusto-Landa J. M., Lopez-Zafra E. (2012). Sources of stress in nursing students: A systematic review of quantitative studies. Int. Nurs. Rev. 59, 15–25. 10.1111/j.1466-7657.2011.00939.x
    1. Rathnayake S., Ekanayaka J. (2016). Depression, anxiety, and stress among undergraduate nursing students in a public University in Sri Lanka. Int. J. Car. Sci. 9, 1020–1032.
    1. Ricci-Cabello I., Meneses-Echavez J. F., Serrano-Ripoll M. J., Fraile-Navarro D., de Roque M. A. F., Moreno G. P., et al. . (2020). 10.1101/2020.04.02.20048892
    1. Riva G., Bernardelli L., Browning M., Castelnuovo G., Cavedoni S., Chirico A., et al. . (2020). COVID Feel good-an easy self-help virtual reality protocol to overcome the psychological burden of coronavirus. Front. Psychiatry 11:563319. 10.3389/fpsyt.2020.563319
    1. Riva G., Riva E. (2020). COVID feel good: a free vr self-help solution for providing stress management and social support during the COVID-19 pandemic. Cyberpsychol. Behav. Soc. Netw. 23, 652–653. 10.1089/cyber.2020.29195.ceu
    1. Schnall P. L., Schwartz J. E., Landsbergis P. A., Warren K., Pickering T. (1992). Relation between job strain, alcohol, and ambulatory blood pressure. Hypertension 19, 488–494. 10.1161/01.HYP.19.5.488
    1. Shirey M. R. (2006). Stress and coping in nurse managers: two decades of research. Nurs. Econ. 24:193.
    1. Singh R. K., Jain M. (2017). Efficacy of self-management techniques in reducing perceived occupational stress among nursing staff. Ind. J. Positiv. Psychol. 8:360–365.
    1. Tyler P., Cushway D. (1995). Stress in nurses: The effects of coping and social support. Stress Med. 11, 243–251. 10.1002/smi.2460110140
    1. Velana M., Rinkenauer G. (in press). Developing a methodology to examine psychophysiological responses during stress exposure and relaxation: an experimental paradigm, in ICHPS 2021: 23th International Conference on Health Psychology and Stress, Istanbul, Turkey, (accessed Nov 7, 2021).
    1. Villani D., Grassi A., Cognetta C., Toniolo D., Cipresso P., Riva G. (2013). Self-help stress management training through mobile phones: an experience with oncology nurses. Psychol. Serv. 10, 315–322. 10.1037/a0026459
    1. Walker M. J. (2006). The effects of nurses' practicing of the HeartTouch technique on perceived stress, spiritual wellbeing, and hardiness. J. Holist. Nurs. 164–175. 10.1177/0898010105283343
    1. Wang S. C., Wang L. Y., Shih S. M., Chang S. C., Fan S. Y., Hu W. Y. (2017). The effects of mindfulness-based stress reduction on hospital nursing staff. Appl. Nurs. Res. 38, 124–128. 10.1016/j.apnr.2017.09.014
    1. Yang J., Tang S., Zhou W. (2018). Effect of mindfulness-based stress reduction therapy on work stress and mental health of psychiatric nurses. Psychiatr. Danub. 30, 189–196. 10.24869/spsih.2018.189
    1. Zautra A. J., Hall J. S., Murray K. E. (2010). Resilience: a new definition of health for people and communities, in Handbook of Adult Resilience, eds Reich J. W., Zautra A. J., Hall J. S. (New York, NY: The Guilford Press; ), 3–29.
    1. Zhang X., Bachmann P., Schilling T. M., Naumann E., Schachinger H., Larra M. F. (2018). Emotional stress regulation: the role of relative frontal alpha asymmetry in shaping the stress response. Biol. Psychol. 138, 231–239. 10.1016/j.biopsycho.2018.08.007

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